﻿<%@ Page Language="C#" MasterPageFile="~/Site1.Master" AutoEventWireup="true" CodeBehind="registration.aspx.cs" Inherits="HCPPA.registration" Title="Untitled Page" %>
<asp:Content ID="Content1" ContentPlaceHolderID="head" runat="server">
    <style type="text/css">

.stylepp {font-size: 14px;
	font-family: "Microsoft Sans Serif";
	font-weight: bold;
	color: #0099FF;}
.style2 {color: #FF0000}
</style>
</asp:Content>
<asp:Content ID="Content2" ContentPlaceHolderID="ContentPlaceHolder1" runat="server">
    <table width="797" height="419" border="0" align="center" cellpadding="0" cellspacing="0" bgcolor="#F4F4F4">
    <tr bgcolor="#FFFFFF">
        <td height="36" colspan="7">
            <span class="stylepp">Members Registration Form </span>
        </td>
    </tr>
    <tr>
        <td height="39" colspan="2">
            <span class="style1">&nbsp;&nbsp;Fullname</span></td>
        <td colspan="5" valign="middle" class="style1">
            <div align="left">
                <input name="textfield222223" type="text" id="textfield222223" value="" 
                    size="97" /> <span class="style2">*</span></div>
        </td>
    </tr>
    <tr>
        <td height="34" colspan="2">
            <span class="style1">&nbsp;&nbsp;Date of Birth&nbsp;&nbsp;&nbsp;</span></td>
        <td colspan="2" valign="middle" class="style1">
            <div align="left">
                <input name="textfield222224" type="text" id="label" size="15" />
                <span class="style2">*</span></div>
        </td>
        <td valign="middle" class="style1">
            &nbsp;</td>
        <td valign="middle" class="style1">
            &nbsp;</td>
        <td valign="middle" class="style1">
            &nbsp;</td>
    </tr>
    <tr>
        <td height="39" colspan="2">
            <span class="style1">&nbsp;&nbsp;Occupation</span></td>
        <td colspan="2" valign="middle" class="style1">
            <div align="left">
                <input name="textfield22" type="text" id="textfield222224" size="30" />
                <span class="style2">*</span></div>
        </td>
        <td width="23" valign="middle" class="style1">
            &nbsp;</td>
        <td width="243" valign="middle" class="style1">
            &nbsp;</td>
        <td width="118" valign="middle" class="style1">
            &nbsp;</td>
    </tr>
    <tr>
        <td colspan="2" class="style1">
            &nbsp;&nbsp;Office Address&nbsp;</td>
        <td colspan="2" valign="middle" class="style1">
            <div align="left">
                <textarea name="textarea2" cols="25" rows="3" id="label2"></textarea>
            </div>
        </td>
        <td colspan="3" valign="middle" class="style1">
            <div align="left">
                <table width="369" border="0" align="right">
                    <tr>
                        <td width="97">
                            <label for="label3">
                            &nbsp;&nbsp;Email</label>
                            &nbsp;&nbsp;&nbsp;&nbsp;</td>
                        <td width="262">
                            <input name="textfield222" type="text" class="style1" id="textfield22" size="50" /></td>
                    </tr>
                    <tr>
                        <td valign="middle">
                            &nbsp;&nbsp;Telephone No</td>
                        <td>
                            <input name="textfield2222" type="text" class="style1" id="textfield222" size="25" /></td>
                    </tr>
                    <tr>
                        <td height="34">
                            &nbsp;&nbsp;MobileNo</td>
                        <td>
                            <input name="textfield22222" type="text" class="style1" id="textfield2222" size="25" /></td>
                    </tr>
                </table>
            </div>
        </td>
    </tr>
    <tr>
        <td height="30" colspan="2" class="style1">
            &nbsp;</td>
        <td colspan="2" valign="middle" class="style1">
            &nbsp;</td>
        <td colspan="3" valign="middle" class="style1">
            &nbsp;</td>
    </tr>
    <tr>
        <td colspan="2" valign="middle" class="style1">
            &nbsp;&nbsp;Private &nbsp; Address&nbsp;&nbsp;</td>
        <td colspan="2" valign="middle" class="style1">
            <div align="left">
                <textarea name="textarea" cols="25" rows="3" id="textarea"></textarea>
                <span class="style2">*</span></div>
        </td>
        <td colspan="3" valign="middle" class="style1">
            <div align="left">
                <table width="363" border="0" align="right">
                    <tr>
                        <td width="100">
                            <label for="label3">
                            &nbsp;&nbsp;Email</label>
                            &nbsp;&nbsp;&nbsp;&nbsp;</td>
                        <td width="253">
                            <input name="textfield2223" type="text" class="style1" id="textfield2223" size="50" /></td>
                    </tr>
                    <tr>
                        <td height="23" valign="middle">
                            Telephone No</td>
                        <td>
                            <input name="textfield22223" type="text" class="style1" id="textfield22222" size="25" />
                            <span class="style2">*</span></td>
                    </tr>
                    <tr>
                        <td height="32">
                            &nbsp;&nbsp;MobileNo</td>
                        <td>
                            <input name="textfield222222" type="text" class="style1" id="textfield222222" size="25" />
                            <span class="style2">*</span></td>
                    </tr>
                </table>
            </div>
        </td>
    </tr>
    <tr>
        <td height="28" colspan="2" valign="middle" class="style1">
            &nbsp;</td>
        <td width="73" valign="middle" class="style1" align="center">
            From : 
        </td>
        <td width="184" valign="middle" class="style1">
            To:</td>
        <td valign="middle" class="style1">
            &nbsp;</td>
        <td valign="middle" class="style1">
            &nbsp;</td>
        <td valign="middle" class="style1">
            &nbsp;</td>
    </tr>
    <tr>
        <td width="6" height="22" align="left" valign="middle" class="style1">
            &nbsp;</td>
        <td width="150" align="left" valign="middle" class="style1">
            You are a Student of Hartley: &nbsp;</td>
        <td colspan="3" valign="middle" class="style1">
            <input name="textfield23" type="text" id="textfield23" size="8" />
            <input name="textfield24" type="text" id="textfield24" size="8" />
            <div align="left">
            </div>
        </td>
        <td valign="middle" class="style1">
            &nbsp;</td>
        <td valign="middle" class="style1">
            &nbsp;</td>
    </tr>
    <tr>
        <td height="22" align="left" valign="middle" class="style1">
            &nbsp;</td>
        <td align="left" valign="middle" class="style1">
            &nbsp;</td>
        <td colspan="3" valign="middle" class="style1">
            &nbsp;</td>
        <td valign="middle" class="style1">
            &nbsp;</td>
        <td valign="middle" class="style1">
            &nbsp;</td>
    </tr>
    <tr>
        <td height="22" align="left" valign="middle" class="style1">
            &nbsp;</td>
        <td align="left" valign="middle" class="style1">
            &nbsp;</td>
        <td colspan="3" valign="middle" class="style1">
            &nbsp;</td>
        <td valign="middle" class="style1">
            &nbsp;</td>
        <td valign="middle" class="style1">
            <form id="form2" name="form1" method="post" action="">
            <input name="Submit3" type="submit" class="style1" id="Submit0" 
                value="Submit" />
            <input name="Submit2" type="reset" class="style1" id="label3" value="Reset" />
            </form>
        </td>
    </tr>
</table>
</asp:Content>
